‘I’ve been likened to a Holocaust denier’

American academic Joan Wolf tells spiked why the militant lactivists of the breastfeeding lobby found her book Is Breast Best? so hard to swallow.

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28 January 2013

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In a classic displacement activity, before writing this article I asked the computer to define breastfeeding. In the top results, one free online medical dictionary defined it as ‘the method of feeding a baby with milk directly from the mother’s breast’, while the World Health Organisation defined it like this: ‘Breastfeeding is the normal way of providing young infants with the nutrients they need for healthy growth and development. Virtually all mothers can breastfeed, provided they have accurate information, and the support of their family, the healthcare system and society at large.’

That pretty much sums up the breastfeeding issue, as it appears in Britain and America in 2013. On one hand, you have the practice of breastfeeding – one way in which mothers feed their new babies. On the other, you have the politics of breastfeeding – the way in which mothers are supposed to feed their new babies.

In the first definition, there are alternatives to breastfeeding; mothers (or indeed, any adults) can feed babies with expressed breastmilk or formula milk. In the second definition, alternatives to breastfeeding are de-normalised and deviant; mothers who choose alternative methods are failing to meet the basic standard set by what ‘virtually all mothers’ can do, and harming their infant’s chances of ‘healthy growth and development’.

Mothers of new babies are only too aware of the politics of breastfeeding. As in many other areas of women’s reproductive lives, the shift from ‘is’ to ‘ought’ has been played out with a vengeance: because science tells us that breastfeeding is better for your infant than formula feeding, new parents are told, then to be a good mother you ought to breastfeed. Research from the University of Kent in 2005 revealed the degree to which this exhortation can make new mothers feel guilty, upset and angry when they ‘fail’ to breastfeed for any length of time – and as the vast majority of mothers stop breastfeeding after six weeks, that’s a lot of guilt.

But it’s not only the effect of breastfeeding promotion on new mothers that should concern us. In 2011, the American academic Joan Wolf, associate professor of women’s studies at Texas A&M University, caused a storm with her book Is Breast Best? Taking on the Breastfeeding Experts and the New High Stakes of Motherhood. And on 13 February, Wolf will expand on her arguments in an open lecture at the University of Kent on ‘Breastfeeding, motherhood, and the politics of care’. I talked to her about the reaction to her critique of breastfeeding, and how this has led her to think about the politics of care more broadly.

You can’t say that!

‘I didn’t set out to write this book’, Wolf tells me. ‘In fact, I assumed breast was best. What I was interested in was how feminists had thought about breastfeeding, a practice that, for all intents and purposes, really can’t be shared with the baby’s father.’ But this quickly led to an awareness that there was more to the story than simply the acceptance of a scientific truth. Drawn into an investigation of the numerous scientific studies cited by those who make the claim that ‘breast is best’, Wolf found that, in fact, the evidence is far less clear cut than it is presented to be.

As she explains in the preface to her book: ‘When studies find an association between breastfeeding and reduced risks [to infant health]… it is not at all clear that one causes the other, and the conclusion that breastfeeding confers health benefits is far less certain than its proponents contend. Indeed, a great deal of evidence suggests that the difference between breastfeeding and bottle-feeding has little impact on the overwhelming majority of infants in the developed world.’

One might think that Wolf’s research would be greeted both as a good news story, and as something not particularly surprising. After all, given the decades of research and millions of dollars that have gone into developing formula milk as a suitable alternative to breastmilk, the fact that in developed societies – where women can afford to buy enough formula, and have the means to sterilise the bottles – the majority of women are not harming their babies’ health by bottle-feeding is a good thing, right? If the issue here is public health, surely what counts is that babies (and their mothers) are healthy?

Er, no. Because what Wolf found, along with others who have dared to research the claims made about breastfeeding, is that You Can’t Say That. The feedback to her book has, she says, ‘been copious and mostly negative’: ‘I’ve been placed in the same camp as Holocaust deniers and advocates of cold fusion. I’ve been accused of hating mothers and children. I’ve also been called a lesbian (gasp) and a feminist (double gasp). One person called me a gender-confused cow.’

This reaction has not just come from advocacy groups and hotheads in the media and policy worlds. Academics – whose role in life is to debate and search for the truth – have, Wolf says, been ‘less churlish but equally unequivocal’: ‘Those who consider themselves scientists accuse me, sometimes with bemusement, of being completely unqualified to judge breastfeeding research… even though, as a PhD in political science, I have been trained in the very methods breastfeeding studies use. Those who write from the humanities dismiss me as part of a broad feminist conspiracy against motherhood. Mostly critics think I’m just plain daft.’

Daft she certainly is not. Wolf is a fiercely intelligent mother-of-two, and a thoroughly nice person to boot. But as she has found, those who attempt to clarify ‘The Science’ around breastfeeding are often met with the furious riposte that they cannot understand this complex information: a classic way in which the ‘evidence-based’ policy and advocacy so in vogue today attempts to clamp down on debate. Those who challenge the orthodoxy of breastfeeding promotion are also met with the eye-rolling assumption that they are alone in their peculiar view that the truth is more complex than a narrow set of correlations, and deliberate attempts to isolate them from mainstream acceptable opinion.

Yet Wolf is not the only person to have found the science on breastfeeding more equivocal than the headlines and public-health advice imply. In just one recent example, an article by the British science journalist Linda Geddes, author of Bumpology, noted that while breastmilk is indeed ‘better than formula milk’ in terms of protecting babies against infections in the short term, ‘when it comes to the much-touted long-term benefits of breastfeeding, such as protection against obesity, diabetes or allergy, the research is less convincing’. Geddes concluded: ‘Certainly women who can’t breastfeed for whatever reason, and who live in countries with a decent standard of healthcare, shouldn’t waste too much time worrying that they are causing long-term damage to their baby’s health.’

More importantly, for all the flak Wolf has received from those attached to the ‘breast is best’ advocacy message, the correspondence she has received from mothers in Britain and the US has confirmed the correctness of her analysis of some of the problems caused by the exhortation to breastfeed. Many of these women, she says, ‘tell nightmarish stories of early parenthood involving unsuccessful breastfeeding, zealous and often callous breastfeeding advocates, and the fear that their bottle-fed infants would be permanently disadvantaged’. She has also heard from ‘lactation consultants’, people who want to help women breastfeed but have been appalled at the coercive aspect of current breastfeeding promotion, and tell of ‘new mothers consumed by guilt, and they question the moral and practical wisdom of pushing all mothers to breastfeed’.

‘Total motherhood’

A rational approach to public-health policy would accept that breastfeeding has health benefits relative to formula feeding, but that these are specific and limited, and cannot justify the effort that the health service puts into exhorting new mothers to breastfeed at all costs - particularly when the consequence seems to be a great deal of misery and anxiety on the part of mothers. So why has this policy push been so one-sided? ‘From a public-health perspective, breastfeeding is healthier than bottle-feeding, and promoting it is a no-brainer because it’s “natural” and “free”’, Wolf explains. ‘Who wouldn’t advocate something that enhances the short and long-term physical and mental health of babies and mothers, requires no public or medical intervention, is good for the environment, and doesn’t cost anything for government, employers, and families?’

Wolf goes on to counter this justification with ‘the rub’: that ‘most of the putative health benefits of breastfeeding are dubious, and breastfeeding is neither natural nor free’. It is not natural, in that women have always found alternative or supplementary ways of feeding their infants, and the idea of what is ‘natural’ today is constructed by a whole number of social, ideological and cultural factors. As she writes in her book, ‘In American public discourse, breastfeeding is a trope in causes resonating from environmental progressivism to religious fundamentalism’; and the amount of effort and public money that goes into encouraging women to breastfeed and ‘supporting’ them in doing so indicates that it is far from being something that women ‘just do’.

The notion that breastfeeding is ‘free’ ignores the fact that breastfeeding women need extra nutrition to produce their milk, and – more importantly, in modern Western societies – there are direct costs associated with exclusive breastfeeding for a long period of time, such as when it delays women’s return to their paid jobs. Hence the importance of her critique of the overblown scientific claims made about breastfeeding, and her recognition of the need to look at the cultural and social context in which women have fed their babies over the years, which reveal these practices to be anything but ‘natural’.

In her book, Wolf discusses a deeper rationale for why breastfeeding promotion has continued apace, despite all the problems with the ‘breast is best’ message, which she describes as an ideology of ‘total motherhood’, framed within a wider ‘risk culture’. Total motherhood, writes Wolf, ‘stipulates that mothers’ primary occupation is to predict and prevent all less-than-optimal social, emotional, cognitive, and physical outcomes; that mothers are responsible for anticipating and eradicating every imaginable risk to their children, regardless of the degree or severity of the risk or what the trade-offs might be; and that any potential diminution in harm to children trumps all other considerations in risk analysis as long as mothers can achieve the reduction’. In short, it is a ‘moral code in which individual mothers are ultimately held responsible for any harm that befalls their children’.

Like Frank Furedi’s analysis of ‘paranoid parenting’, Wolf’s theory of ‘total motherhood’ shows how our current society’s obsession with risk and uncertainty has resulted in a highly deterministic approach to parental behaviour, in which a parent’s behaviour and identity is constructed around the goal of keeping children safe from all manner of hypothetical harms. This goal is, of course, unachievable (all kids will have accidents and health problems at some point in their lives, no matter what we do); yet in striving to achieve the goal we diminish our ambitions and narrow our vision. Wolf notes that ‘total motherhood is rooted in the traditions of domesticity and “scientific motherhood”’, where women’s primary focus is on the private responsibilities of child-rearing, which she is instructed to do under expert advice.

One important difference between now and the era of scientific motherhood, however, is the extent to which the project of ‘risk management’ has become deeply ingrained into parents’ own identity, in a context where we are in thrall to an avalanche of scientific advice but less trusting of professionals to interpret this (often conflicting) advice for us. ‘Never before has information been so comprehensive and widely available and reached so far into individual lives, holding out the promise of manipulating increasingly narrower details of existence’, Wolf writes. This leads to a situation that ‘sets women, future mothers, and then mothers the impossible task of gathering, evaluating, and acting on information about an infinite number of risks that might interfere with not just normal but optimal fetal and child development’.

Within the confines of total motherhood, good mothers don’t drink alcohol or eat cheese in pregnancy; they breastfeed their babies and read obsessively to their toddlers; they supervise their older children’s every social interaction and hover over their schoolwork in fear of a tiny fall in grades. Good mothers don’t just worry about health risks but all risks - for even the most mundane aspects of social life, such as falling out with friends, have now been reconfigured as events that can damage irrevocably a child’s future chances of success and happiness.

This obsessive monitoring and worrying makes us very stressed and often quite miserable. And yet, we buy it! In the casual conversations of everyday life, mothers (and fathers) joke about the impossibility of living up to the standards of total motherhood, and implicitly resist the desirability of organising your whole life around the minutiae of what your child ate for lunch and whether he is playing with the right number of the right friends. But in wider discourse, it is very rare to hear parents say that they don’t actually care whether their child eats five pieces of fruit and vegetables a day, or that they want bossy officials to leave them alone and let them worry about something more important instead. Rather, strategies of resistance to the ideology of total motherhood tend to be evasive and apologetic, couched less in the language of ‘I won’t’ than in the language of ‘I can’t’.

Related categories

This is particularly clear when it comes to breastfeeding - for as Wolf explains, ‘these days it is virtually impossible to make a real choice about how to feed your baby’, as ‘the options are so skewed toward breastfeeding, the discourse so laden with moral freight, that breastfeeding appears to be the only legitimate option.’

She continues: ‘Of course, most women do end up using formula, and what I find interesting is that those who explain themselves publicly, on blogs and in books and articles, tend to stress either that they had no choice (for example, they couldn’t produce enough milk, the baby wouldn’t latch on) or that formula feeding was better for the baby in their particular circumstances. In other words, mothers have internalised and accepted that they should breastfeed, and when they don’t, they look for ways to convey that the decision was made for the baby’s benefit. Few mothers will say, “I didn’t breastfeed because I didn’t want to”, and leave it at that.’

The morally fraught character of what is, essentially, a practical choice about how best to feed your baby is not confined to breastfeeding. The way that people now worry about and apologise for their everyday behaviours and choices has to do, Wolf explains, with ‘how people justify seemingly irresponsible behaviour in a neoliberal culture, where choice is completely bound up with moral responsibility and every choice says something about your integrity as a person’. For Wolf, this explains the policy turn towards ‘nudging’ people towards better behaviours: a strategy that is, in her view, ‘even more objectionable than bans because it masquerades as “choice”, a word that invariably conceals the social structures that stratify compliance’.

The politics of care

I ask Wolf to elaborate on her thoughts about the politics of care, which she will be discussing in her February lecture. ‘The first questions I had after writing Is Breast Best? and confronting its reception had to do directly with mothers and children’, she explains. ‘How do we reject total motherhood without abandoning children? How can we agitate for the needs of families without conflating mothers’ and children’s wellbeing or pitting mothers and children against each other?

‘But the more I reflected, the more I realised that total motherhood has to do with far more than mothers and children. It’s about women and caring, the reality that women do the lion’s share of all care work. I want to look more at the relationship between what I call total motherhood and caring more broadly defined. It seems to me that breastfeeding is only one example of a much more comprehensive narrative in which women are constructed as the natural and optimal providers of virtually all forms of care, and in a society where caretaking is unsupported, this kind of thinking puts women at serious disadvantage.’

There is an important body of sociological work in the US, by Arlie Russell Hochschild and others, which grapples with the problem of ‘care’ in late modern societies. As women’s participation in the workforce has become accepted and expected, and as women are assumed to have ambitions beyond the confines of home and family, the taken-for-granted nature of care has become complicated and challenged – particularly in relation to young children or the elderly, where care involves very practical commitments of time and money.

Some approaches to this question - like Wolf’s - emphasise the impact upon women. ‘I think we need to unpack the reflexive coupling of mothers and children in political discourse as part of a broader effort to rearticulate what it means to be a society that actually cares about people’, she explains. ‘The truth is that the more we advocate for “mothers and children”, the more we cement the notion that women are uniquely responsible for caretaking, and this has far-reaching consequences for virtually everyone: children; mothers and fathers who are married or single, straight or gay; men and women without children; elderly parents; extended families; and communities.’

In attempting to unpack this problem, Wolf has been drawn again to a critique of science. ‘Because we tend these days to look to science to tell us how to do everything, I think it’s critical to investigate the role that different sciences play in constructing women as caretakers’, she says. ‘At the moment I’m immersed in analysing a 20-year-long government-funded study on childcare, and what I’m finding is that the social-science research, not unlike the epidemiological research on breastfeeding, is fraught with all kinds of undemonstrated assumptions about mothers. My hope is that if we can continue to deconstruct the scientific narrative about total motherhood, we can begin to recast, and think more equitably about, all kinds of caring.’

The debate about care is a huge one, which raises questions about everything from the role of the family to the current status of women. But I am already convinced that Wolf is right on one thing: the answer to this social question is not going to be found in the pages of scientific studies.

Jennie Bristow is editor of bpas Reproductive Review and author of Standing Up To Supernanny and co-author of Licensed to Hug. (Buy these books from Amazon (UK) here and here.)

Joan Wolf’s open lecture, ‘Is Breast Really Best? Breastfeeding, Motherhood, and the Politics of Care’, will take place at 6pm on Wednesday 13 February 2013, Grimond Lecture Theatre, University of Kent. For further information, contact Ellie Lee at the Centre for Parenting Culture Studies: E.J.Lee@kent.ac.uk